There’s a revelation that comes about halfway through Last Night in the OR: A Transplant Surgeon’s Odyssey by Bud Shaw, M.D. The title leads you to believe you’ll be reading a medical memoir, a genre that has drawn a lot of attention recently with fine books by Henry Marsh (Do No Harm) and Atul Gawande (Being Mortal). Dr. Shaw’s new book traces his evolution from an impressionable 31-year-old surgical resident in Utah through his years of training in what was then the relatively new field of liver transplantation, as well as other significant life events—marrying, divorcing, being fired, undergoing treatment for lymphoma, and getting older and shifting into a new life as a writer. Along the way, we meet the kind of characters you might encounter in a novel: Renowned transplant surgeon Dr. Thomas E. Starzl, one of the most ornery, foul-mouthed, caustic human beings you’d never want to entrust your life to—except for the fact that he was brilliant, fearless and demanded the best out of his team: the taciturn and efficient Dr. Shun Iwatsuki, Dr. Hong from Shanghai (dubbed the Human Retractor for his skill at retracting a patient’s rib cage out of Dr. Starzl’s way), Dr. Carlos Fernandez-Bueno, and Shaw. We meet many patients, in chapters with titles like “Janie and the Giant Abscess,” “Death 5, Mrs. Rothstein l” and “Burned Yolanda.” Shaw’s father, also a doctor, is a major presence, and the emotional thru-line of a father-son relationship complicated by a shared vocation is finely drawn.
So here is the revelation: Medical humanities has found its Raymond Carver. Dr. Shaw’s writing is a true departure from the other brilliant books in this genre because of the distinctive way he tells his stories. His writing is taut, spare and direct, but also gracefully nuanced. We feel we’re getting a factual accounting of events, but also the bigger, more symbolic picture of a time and place and the lives within it. There is a visceral recognition of the physical and psychological toll exacted on physicians and the real fears associated with a job that deals with life and death on a daily basis. Yet, thankfully, the writing never succumbs to sentimentality or philosophizing. Like Carver, Dr. Shaw lays out the Big Issues by making the little worlds we live in alive and real on the page.
Here’s how the chapter “Good Opera” begins:
On the table lay a man from Kansas. He had a wife, two daughters under five, and a bad liver. He had a belly full of fluid, skin glowing like a pumpkin, and a nest of veins like snakes between my knife and his liver.
I looked into the eyes of four surgeons scrubbed and waiting to help me. Shun was in the lounge smoking. He’d helped me do dozens of transplants by then and he figured I’d call for him if I got into trouble. Hong, the Human Retractor, grinned at me. I asked for the knife and we began.
As with any medical memoir, expect a few squeamish moments (that is, if you’re not a clinician used to talk about fluids, blood, diseases, etc.). Expect, also, to be moved by a doctor’s tales, expressed succinctly and with great depth and feeling.—Donna Bulseco
DONNA BULSECO, M.A., M.S., is a graduate of the Narrative Medicine program at Columbia University and Managing Editor of Intima: A Journal of Narrative Medicine. After doing undergraduate work at UCLA in creative writing and American poetry, the L.A. native studied American Gothic and English at Brown University, then moved to New York City in the late seventies. She has been an editor and journalist for the past 25 years at publications such as Women's Wear Daily, W, Self, and InStyle, and has written articles for Health, More, Redbook, and the New York Times.